Diabetes and Retinopathy

Diabetes is a metabolic condition that affects millions of people all over the world. It is defined as high levels of glucose in the blood caused by insufficient insulin to convert glucose into energy for the cells. The pancreas releases insulin in response to high levels of glucose that left unchecked can result in complications, some of which are life threatening.

A major complication of having diabetes is Diabetic Retinopathy, a group of eye diseases caused by increased levels of glucose that lead to damage to the blood vessels of the eye. Consistently high glucose levels cause damage to body organs such as the kidneys, heart, nerves, and eyes.

Diabetic retinopathy is characterized as swelling of the vessels, which lead to the leakage of eye fluid. Initially, damage is not noticed until the person begins to have problematic visual impairments, such as blurry vision. Approximately 45% if diabetic patients have diabetic retinopathy to some degree. It is held to be one of the leading causes of blindness.

Other eye diseases related to diabetes:

• Cataracts: Clouding or yellowing of the eye lens causing blurred vision and halos around objects. Can lead to blindness if not treated.


• Glaucoma: Increased fluid pressure inside the eyes causing damage leading to vision loss.

Two Types of Diabetic Retinopathy:

Nonproliferative: Is retinopathy in it's early stages characterized by blurred vision. There are small areas of swelling in the vessels of the retina that can leak fluid.

Proliferative: Is more advanced that causes scarring of the retina and subsequent loss of vision. The vessels of the retina become narrowed which decreases blood flow to the eye.

Stages range from mild to severe, which cause new and abnormal vessels to form that can leak blood into the retina. This leads to edema of the retina that can result in blindness.

What are the risks?

The longer a person lives with diabetes puts them at increased risk. Persons who have problems controlling their diabetes symptoms, elevated cholesterol and triglyceride levels, hypertension, and those who smoke are at risk for diabetic retinopathy. Women who are pregnant and have diabetes have a far greater risk for development of this eye condition.

What are the symptoms?

• Floating spots


• Dark streaks that obscure vision


• Shadows or blank spaces of vision


• Blurry vision


• Problems seeing at night


• Vision loss

Severe complications include:

• Hemorrhage of vitreous fluid


• Detached retina


• Glaucoma


• Blindness

How is diabetic retinopathy diagnosed?

At the first sign of symptoms you should contact your health care provider for a consultation. The examination involves dilation of the pupils with eye drops to enable the doctor to see the retina and it's blood vessels. He looks for abnormal growth of new vessels, as well as swelling, bleeding, and nerve damage.

Your doctor may also perform fluorescein angiography and optical coherence tomography (OCT) to determine if diabetic retinopathy exists and to what extent.

How is retinopathy treated?

Treatment focuses on halting progression and preventing further damage. No treatment is needed for the non-proliferative stage, but laser treatment is available if warranted. Your doctor can advise you if this is right for you.

In the advanced stages, surgery may be required, which may slow the disease progression. Regular eye exams with your doctor are highly advised.

How can this be prevented?

The best way to prevent diabetic retinopathy is to take extra good care of yourself with a healthy diabetic diet, control of glucose levels, get regular exercise at least three times per week, and proper administration of your insulin medications.

by Barb Hicks, RN/LMT